RT Journal Article
SR Electronic
T1 Thoracic malignancies and pulmonary nodules in patients under evaluation for transcatheter aortic valve implantation (TAVI): Incidence, follow up and possible impact on treatment decision
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA2905
DO 10.1183/13993003.congress-2015.OA2905
VO 46
IS suppl 59
A1 Vietmeier, Benedikt
A1 Bröckling, Sebastian
A1 Kaleschke, Gerrit
A1 Görlich, Dennis
A1 Schülke, Christian
A1 Thrull, Michael
A1 Baumgartner, Helmut
A1 Berdel, Wolfgang E.
A1 Wiewrodt, Rainer
A1 Mohr, Michael
A1 Schmidt, Lars Henning
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/OA2905.abstract
AB Introduction: TAVI is the treatment of choice in patients with severe aortic stenosis who are not eligible for operative replacement. Due to high age and smoking history of TAVI patients, pulmonary nodes (PN) and thoracic malignancies are frequently observed.Methods: Pre-procedural CT scans of 487 patients (median age 82 yrs, female 58%) were reevaluated for incidentally discovered thoracic malignancies, pulmonary nodules and lymphadenopathy.Results: Solitary or multiple PN were found in 192 patients (39%; <5 mm: 108 [22%] ≥5mm: n=63 [13%], ≥10mm: n=21 [4%]). Fifty patients with pulmonary nodules (26%) had additional mediastinal or hilar lymphadenopathy. Further diagnostic work-up detected findings suspicious for malignancy in 60 patients and lung cancer was diagnosed in three cases (5% ). After a median follow-up of 17 months, no new lung cancer case was observed in this subgroup. First data analysis did not yield a significant difference in overall survival between PN+ and PN- patients (p>0.05).Conclusions: Despite the high prevalence of PN in this single center TAVI cohort, lung cancer incidence seems to be low. Aggressive diagnostic approaches for incidentally discovered pulmonary nodes during TAVI evaluation may not be indicated. Unless advanced thoracic malignancy is not obvious, both the immediate and often major symptomatic relief following TAVI may outweigh potential harmful delays regarding further diagnostics.